Diabetic peripheral neuropathy - advances in diagnosis and treatment
DOI:
https://doi.org/10.12775/JEHS.2023.25.01.009Keywords
diabetes mellitus, diabetic peripheral neuropathy, neuropathic painAbstract
Diabetes mellitus is one of the most alarming conditions of the 21st century. The prevalence of both type 1 and 2 diabetes is constantly increasing, which also entails a growing number of patients suffering from its various complications. One of the most common chronic complications is diabetic neuropathy (DN), which is developed by at least 50% of patients with diabetes. Diabetic peripheral neuropathy (DPN) is the most frequent type of DN. Clinically, a non-painful and a painful-DPN can be distinguished. The painful type causes a massive decrease in the quality of life and affects around 30% of individuals with DM. In recent years many instruments have been used to diagnose and treat DPN but none of them seems to be sufficient in early diagnosis and satisfactory symptoms management. To date, there is any gold standard to recognize DNP and usually it is noticed when a patient presents symptoms of neuropathy, which is too late to introduce an effective therapy. The main approaches for patients with DNP focus on improving glycaemic control, lifestyle modifications and pain therapy. Multiple medicaments are used for this purpose, among which SNRIs, TCAs and anticonvulsants are most effective. Non-pharmacologic treatment, such as acupuncture, physical therapy, nerve stimulation, also has been used, however their effectiveness remains uncertain.
References
“IDF Diabetes Atlas 10th edition.” [Online]. Available: www.diabetesatlas.org
R. Pop-Busui et al., “Diabetic Neuropathy: A Position Statement by the American Diabetes Association.,” Diabetes Care, vol. 40, no. 1, pp. 136–154, Jan. 2017, doi: 10.2337/dc16-2042.
C. J. Holmes and M. K. Hastings, “The Application of Exercise Training for Diabetic Peripheral Neuropathy.,” J Clin Med, vol. 10, no. 21, Oct. 2021, doi: 10.3390/jcm10215042.
R. Bhandari, A. Sharma, and A. Kuhad, “Novel Nanotechnological Approaches for Targeting Dorsal Root Ganglion (DRG) in Mitigating Diabetic Neuropathic Pain (DNP).,” Front Endocrinol (Lausanne), vol. 12, p. 790747, 2021, doi: 10.3389/fendo.2021.790747.
S. P. Tatikola, V. Natarajan, V. K. Desai, A. R. Asirvatham, and H. Rajsekhar, “Effect of various exercise protocols on neuropathic pain in individuals with type 2 diabetes with peripheral neuropathy: A systematic review and meta-analysis,” Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 16, no. 9, p. 102603, Sep. 2022, doi: 10.1016/j.dsx.2022.102603.
K. Yang et al., “Progress in the treatment of diabetic peripheral neuropathy,” Biomedicine & Pharmacotherapy, vol. 148, p. 112717, Apr. 2022, doi: 10.1016/j.biopha.2022.112717.
M. R. Khdour, “Treatment of diabetic peripheral neuropathy: a review,” Journal of Pharmacy and Pharmacology, vol. 72, no. 7, pp. 863–872, Jun. 2020, doi: 10.1111/jphp.13241.
T. S. Jensen et al., “Painful and non-painful diabetic neuropathy, diagnostic challenges and implications for future management.,” Brain, vol. 144, no. 6, pp. 1632–1645, Jul. 2021, doi: 10.1093/brain/awab079.
D. Ziegler, J. Keller, C. Maier, and J. Pannek, “Diabetic Neuropathy,” Experimental and Clinical Endocrinology & Diabetes, vol. 129, no. S 01, pp. S70–S81, Aug. 2021, doi: 10.1055/a-1284-6245.
S. Akter, M. Choubey, M. M. Mohib, S. Arbee, M. A. T. Sagor, and M. S. Mohiuddin, “Stem Cell Therapy in Diabetic Polyneuropathy: Recent Advancements and Future Directions.,” Brain Sci, vol. 13, no. 2, Feb. 2023, doi: 10.3390/brainsci13020255.
K. Oliveira-Abreu, J. Cipolla-Neto, and J. H. Leal-Cardoso, “Effects of Melatonin on Diabetic Neuropathy and Retinopathy.,” Int J Mol Sci, vol. 23, no. 1, Dec. 2021, doi: 10.3390/ijms23010100.
A. Bondar et al., “Diabetic neuropathy: A narrative review of risk factors, classification, screening and current pathogenic treatment options (Review).,” Exp Ther Med, vol. 22, no. 1, p. 690, Jul. 2021, doi: 10.3892/etm.2021.10122.
N. H. Strand and A. R. Burkey, “Neuromodulation in the Treatment of Painful Diabetic Neuropathy: A Review of Evidence for Spinal Cord Stimulation.,” J Diabetes Sci Technol, vol. 16, no. 2, pp. 332–340, Mar. 2022, doi: 10.1177/19322968211060075.
E. Cho and W. Kim, “Effect of Acupuncture on Diabetic Neuropathy: A Narrative Review.,” Int J Mol Sci, vol. 22, no. 16, Aug. 2021, doi: 10.3390/ijms22168575.
D. Ziegler et al., “Current concepts in the management of diabetic polyneuropathy.,” J Diabetes Investig, vol. 12, no. 4, pp. 464–475, Apr. 2021, doi: 10.1111/jdi.13401.
R. Pop-Busui et al., “Diagnosis and Treatment of Painful Diabetic Peripheral Neuropathy,” ADA Clinical Compendia, vol. 2022, no. 1, pp. 1–32, Jan. 2022, doi: 10.2337/db2022-01.
E. L. Feldman et al., “Diabetic neuropathy.,” Nat Rev Dis Primers, vol. 5, no. 1, p. 42, Jun. 2019, doi: 10.1038/s41572-019-0097-9.
D. C. Rosenberger, V. Blechschmidt, H. Timmerman, A. Wolff, and R.-D. Treede, “Challenges of neuropathic pain: focus on diabetic neuropathy.,” J Neural Transm (Vienna), vol. 127, no. 4, pp. 589–624, Apr. 2020, doi: 10.1007/s00702-020-02145-7.
Z. Yang et al., “Simple tests to screen for diabetic peripheral neuropathy,” Cochrane Database of Systematic Reviews, Feb. 2014, doi: 10.1002/14651858.CD010975.
J. Carmichael, H. Fadavi, F. Ishibashi, A. C. Shore, and M. Tavakoli, “Advances in Screening, Early Diagnosis and Accurate Staging of Diabetic Neuropathy.,” Front Endocrinol (Lausanne), vol. 12, p. 671257, 2021, doi: 10.3389/fendo.2021.671257.
V. Bril and B. A. Perkins, “Validation of the Toronto Clinical Scoring System for Diabetic Polyneuropathy,” Diabetes Care, vol. 25, no. 11, pp. 2048–2052, Nov. 2002, doi: 10.2337/diacare.25.11.2048.
J. A. Lee, E. M. Halpern, L. E. Lovblom, E. Yeung, V. Bril, and B. A. Perkins, “Reliability and Validity of a Point-of-Care Sural Nerve Conduction Device for Identification of Diabetic Neuropathy,” PLoS One, vol. 9, no. 1, p. e86515, Jan. 2014, doi: 10.1371/journal.pone.0086515.
G. Ponirakis et al., “The diagnostic accuracy of Neuropad ® for assessing large and small fibre diabetic neuropathy,” Diabetic Medicine, vol. 31, no. 12, pp. 1673–1680, Dec. 2014, doi: 10.1111/dme.12536.
C. M. Casellini, H. K. Parson, M. S. Richardson, M. L. Nevoret, and A. I. Vinik, “Sudoscan, a Noninvasive Tool for Detecting Diabetic Small Fiber Neuropathy and Autonomic Dysfunction,” Diabetes Technol Ther, vol. 15, no. 11, pp. 948–953, Nov. 2013, doi: 10.1089/dia.2013.0129.
P. Shillo et al., “Painful and Painless Diabetic Neuropathies: What Is the Difference?,” Curr Diab Rep, vol. 19, no. 6, p. 32, May 2019, doi: 10.1007/s11892-019-1150-5.
S. H. Seyedizadeh, S. Cheragh-Birjandi, and M. R. Hamedi Nia, “The Effects of Combined Exercise Training (Resistance-Aerobic) on Serum Kinesin and Physical Function in Type 2 Diabetes Patients with Diabetic Peripheral Neuropathy (Randomized Controlled Trials),” J Diabetes Res, vol. 2020, pp. 1–7, Mar. 2020, doi: 10.1155/2020/6978128.
S. Ahn and R. Song, “Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy,” The Journal of Alternative and Complementary Medicine, vol. 18, no. 12, pp. 1172–1178, Dec. 2012, doi: 10.1089/acm.2011.0690.
X. Hu, S. Li, G. Yang, H. Liu, G. Boden, and L. Li, “Efficacy and Safety of Aldose Reductase Inhibitor for the Treatment of Diabetic Cardiovascular Autonomic Neuropathy: Systematic Review and Meta-Analysis,” PLoS One, vol. 9, no. 2, p. e87096, Feb. 2014, doi: 10.1371/journal.pone.0087096.
S. A. Abubaker, A. M. Alonazy, and A. Abdulrahman, “Effect of Alpha-Lipoic Acid in the Treatment of Diabetic Neuropathy: A Systematic Review.,” Cureus, vol. 14, no. 6, p. e25750, Jun. 2022, doi: 10.7759/cureus.25750.
M. Gupta, N. N. Knezevic, A. Abd-Elsayed, M. Ray, K. Patel, and B. Chowdhury, “Treatment of Painful Diabetic Neuropathy-A Narrative Review of Pharmacological and Interventional Approaches.,” Biomedicines, vol. 9, no. 5, May 2021, doi: 10.3390/biomedicines9050573.
Z. Putz et al., “Vitamin D in the Prevention and Treatment of Diabetic Neuropathy,” Clin Ther, vol. 44, no. 5, pp. 813–823, May 2022, doi: 10.1016/j.clinthera.2022.03.012.
W. Cross and S. Srivastava, “A Double-Blind, Randomized, Placebo-Controlled Study to Assess the Efficacy of a Nerve Support Formula on Neuropathic Pain in Individuals Suffering from Type II Diabetes Mellitus.,” J Pain Res, vol. 16, pp. 1115–1126, 2023, doi: 10.2147/JPR.S397777.
J. Wei, Y. Wei, M. Huang, P. Wang, and S. Jia, “Is metformin a possible treatment for diabetic neuropathy?,” J Diabetes, vol. 14, no. 10, pp. 658–669, Oct. 2022, doi: 10.1111/1753-0407.13310.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Paula Bigos, Konrad Dendys, Jan Bieniasz, Wojciech Kuźnicki, Igor Matkowski, Piotr Potyrała
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0
Stats
Number of views and downloads: 508
Number of citations: 0
